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PUPILS WHO STUDY IN SCHOOLS THAT, FOR INSTANCE, PROVIDE WATER AND SOAP ARE MORE LIKELY TO WASH HANDS THAN THOSE IN SCHOOLS THAT DO NOT HAVE THE FACILITIES

NAIROBI (Xinhua) — Schools that promote a healthy learning environment for pupils help to improve their academic performances, a team of researchers has said.

The researchers said such schools, among other things, ensure that the institutions have access to water and sanitation facilities and teachers engage pupils frequently on discussions about health.

This promotes teaching and learning thus increasing student’s chances of excelling in their academics.

The researchers from the Nairobi-based African Population and Health Research Center (APHRC) worked with 22 primary schools in two informal settlements in Nairobi, Kenya under an initiative dubbed Health Promoting Schools ( HPS ).

Sanitation MDG is badly off track, but a community-led approach could fix that

Vast sums are wasted on programmes for free toilets, but the community-led total sanitation approach has helped millions avoid often fatal, faecally related infections.

Defecation mapping in progress in a village in the Democratic Republic of Congo, December 2010. This was set up by Tearfund and conducted by the CLTS team from Plan Kenya; 18 people attended this workshop, which 'triggered' action in six villages. Photograph: Philip Vincent Otieno/CLTS

Community-led total sanitation (CLTS) does not sound such a big deal, but it is revolutionary. We have so many “revolutions” in development that only last a year or two and then fade into history. But this one is different. In all the years I have worked in development this is as thrilling and transformative as anything I have been involved in. Let me explain.

Firstly, sanitation and scale: 2.6 billion people need improved sanitation and 1.1 billion defecate in the open. The millennium development goal (MDG) for sanitation is badly off track in most countries, which affects all the other MDGs.

Secondly, sanitation and hygiene matter much more than most people realise. Where they are lacking, the effects are horrendous. Faecally related infections are many. Everyone feels outrage because more than 2 million children are killed by diarrhoea each year. We hear about cholera outbreaks. But who hears about the guts of 1.5 billion people hosting greedy, parasitic, ascaris worms, about 740 million with hookworm voraciously devouring their blood, 200 million with debilitating schistosomiasis or up to 70 million with liver fluke? And what about dysentery, hepatitis, giardia, tapeworms, typhoid, polio, trachoma…?

When Zacharia Rombo and Samuel Agutu came together in 2008, the mission was simple — to develop a system that embraces technology to provide affordable healthcare.

This was informed by past experiences in their careers as chartered insurer and accountant respectively.

The result of this union was the birth of Changamka Micro Health Limited, a private company in the business of health insurance that targets the poor.

“It was after realising that not more than 10 per cent of Kenyans are insured under health schemes that we decided to go this way. The purpose was to get the uninsured poor who are the majority in the population, to a position to plan and afford medical care,” says Mr Rombo.

At the beginning, the initial focus was on general healthcare.

However, this has since changed to include safe maternal healthcare targeting 60 per cent of Kenyan women who deliver outside medical facilities.

Today, Changamka Micro Health is known for its popular smart card — the Changamka card — which allows members to save in advance for medical expenses to cover inpatient and outpatient services.

Unlike the common insurance schemes that restrict members to certain amounts of premiums for specified values of medical cover, the smart card allows for flexible contributions.

This paper examines the politics and the underlying discourses of water provisioning and how residents of Korogocho and Viwandani slum settlements in Nairobi city cope with challenges relating to water access. We use qualitative data from 36 focus group discussions conducted in the two slums to unravel discourses regarding water provisioning in the rapidly growing slum settlements in African cities. Results show that the problems concerning water provisioning within Nairobi slums are less about water scarcity and more about unequal distribution and the marginalisation of slum areas in development plans.

Poor water management, lack of equity-based policies and programmes, and other slum-specific features such as land-tenure systems and insecurity exacerbate water-supply problems within slum areas. It is hard to see how water supply in these communities can improve without the direct and active involvement of the government in infrastructural development and oversight of the water-supply actors. Innovative public-private partnerships in water provision and the harnessing of existing community efforts to improve the water supply would go a long way towards improving the water supply to the rapidly growing urban poor population in Africa.

A community-based organisation in the Kenyan slum area of Kibera set out to clean up garbage and deal with waste water; Ushiriki Wa Safi ended up creating a community cooker that turns waste into an energy source.

Open sewers and piles of garbage are an all too familiar scene in many of Kenya’s poorest urban areas. Local authorities are invisible in most of these slums, and poor public hygiene and the absence of sanitation leaves residents to their own devices to maintain a level of cleanliness and keep diseases like diarrhoea at bay.

But some have seen this as an opportunity to bring about change to communities. Ushirika Wa Safi – (loosely translated, the name means “an association to maintain cleanliness” in Swahili) – a community-based organisation in Kibera, was formed to deal with the garbage problem in Laini Saba, one of the thirteen villages that form Kibera slums, often described as Africa’s largest.

The CBO has come up with a remarkable solution in the form of a community cooker that turns garbage into energy. It is a recycling project that is transforming the lives of local residents.

The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya.

Epidemiological Transition and the Double Burden of Disease in Accra, Ghana

Samuel Agyei-Mensah and Ama de-Graft Aikins

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities.

We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease.

Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities.